Dr. Pollock Delivers Unusual Foreign Aid

Dr. Pollock Delivers Unusual Foreign Aid

In Neil Pollock’s home province of British Columbia, a group called Foreskin Pride has actually held protests against circumcision, the procedure that has formed the heart of Dr. Pollock’s medical career for 20 years. In the crumbling Caribbean nation of Haiti, the operation made him something of a hero. Dr. Pollock spent a week in the country recently, delivering an unusual bit of foreign aid. In a place beset by violence, poverty and the aftermath of 2010’s devastating earthquake, he trained surgeons to perform the almost-painless form of circumcision he has perfected. It is hoped the operation will become a mainstay in the battle against the country’s HIV epidemic, with evidence suggesting the penis-snipping can cut spread of the disease by 60%. Meanwhile, Dr. Pollock earned a surprise visit in Port au Prince from Hollywood philanthropists Sean Penn and Charlize Theron, also now a couple, who watched as he taught his technique. Now he is in talks with Ms. Theron to deliver similar training in Kwa-Zulu-Natal province of her native South Africa, a place harder hit by HIV than almost anywhere in the world. “I felt having this knowledge and this technique, I have an obligation to share it with other doctors in other countries, where it could have such a meaningful impact,” said Dr. Pollock. Circumcision, long a religious rite for Muslims and Jews, remains something of a controversial topic in the medical world, the foreskin-rights movement aside, and numbers of procedures are dwindling. The Canadian Pediatrics Society says the benefits of removing a boy’s foreskin do not outweigh the risks, in terms of pain and possible complications, but that view is far from universal. The American Academy of Pediatrics and, most recently, the U.S. Centers for Disease Control (CDC) have recommended it as a way to prevent HIV and other sexually transmitted diseases. Dr. Pollock dedicates his practice to circumcision and “no-scalpel, no-needle” vasectomies at his Vancouver clinic. Using special techniques to administer the local anesthetic and other modifications, he says he can now carry out a circumcision in about 30 seconds, almost painlessly. “There wasn’t a day that went by … when I didn’t think, ‘How can I improve this, make it safer, minimize discomfort,’ ” he said. “When you focus all your energies on one or two surgeries, you have a lot of mind space to continue to innovate.” After research emerged that circumcision can significantly curb the spread of HIV — the mucosal surface of the foreskin can hasten uptake of the virus — he spent several days in Rwanda in 2009, training doctors there. More recently, Jeff Klausner, a medical professor at the University of California at Los Angeles, discussed with contacts in Haiti the idea of bringing back the largely overlooked procedure there. Though HIV rates have fallen dramatically, the disease still afflicts about one in 50 Haitians, many of whom do not even know they are infected, said Dr. Klausner, a former CDC official in Africa. He asked around for someone to teach the Haitian doctors. Everyone told him Dr. Pollock “had a reputation for being the best in the field and a great trainer.” The only catch is the American had no funding, so Dr. Pollock raised $25,000 himself from friends and family, $10,000 from his own pocket. Circumcision of small babies in Haiti makes particular sense, given the average age of first sexual intercourse for boys is about 13 and 2.5% of teenage sex partners contract the virus, said Jerry Bonhomme, one of the Haitian physicians Dr. Pollock trained. “Within 12 years, most newborn males born today will be protected with circumcision, which has an impact similar to that of a vaccine,” he said. Conditions in and around the Gheskio Health Center in Port au Prince, the largest AIDS and tuberculosis hospital in the Americas, were not ideal. The walls crawled with mosquitoes that carried chikungunya, a nasty virus causing severe joint pain that is epidemic in Haiti. Then there was the armed riot that erupted over an unpopular government decree. In the end, though, Dr. Pollock and his trainees managed to circumcise more than 100 babies. Now, Dr. Bonhomme will not only be able to apply the skills himself, but eventually teach others.